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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
Question Title: nerve damage or relaxed pelvic floor?Forum: The Urology Forum
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I am a 41y.o. female with 2 children (2 & 6). I first started noting urinary leakage after the birth of my first child when I would jog. and sometimes with a lot of sneezing and coughing. This stayed about the same after the birth of my second child (both were small to medium babies, and I have a medium build). In Jan. I was diagnosed with a large neuronoma at L1/T12 that had been causing back pain and sciatica. This was surgically removed in early Feb. Since that time my back symptoms have improved dramatically. I have recently started jogging again a small bit, but much to my chagrin I have noticed I am still having urine leakage.Any ideas about the diagnotic picture and treatment? Thanks! Dear NN Thanks for your questions. It sounds like you have stress incontinence, but it can be difficult to tell especially since you have a history of a neurologic lesion. Here is some general information to see what best applies to you. Behavior modification is the first line of treatment for Stress and Urge incontinence. Volitional urination before the urge is felt (timed voiding) and decreasing the amount of fluid intake, especially caffeine, are ways of decreasing the amount and frequency of leakage. Kegel exercises are also helpful for the well motivated patient. Antihistamines like phenylpropinolamine, are over the counter meds which can help tighten the sphincter(outlet) of the bladder and may help stress incontinence if leakage is a small amount. Surgery is usually for patients who have failed conservative therapy and may require overnight admission. If you are considering surgery, urodynamics ( a bladder test which looks at the filling and emptying of the bladder) may be recommended by your urologist. This test helps rule out other contributing factors which may compromise your surgical results. Two surgical options are available and one may be more suited based on your pelvic exam. Collagen injection of the bladder neck (performed as an outpatient) may help patients who leak urine very readily. A bladder suspension is indicated for women who’s bladder drops down when straining or coughing. Dr. Kirkemo is a specialist in female urology at Henry Ford Hospital and would be happy to evaluate you in person. If interested please call 1800-653-6568 for an appointment. We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. Hope this information has helped and good luck. Sincerely; HFHS-M.D.-MS * Keyword: incontinence, stress urinary incontinence
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